| 标题： | 出院准备服务循证指南 |
| title： | Evidence based Guidelines for hospital discharge planning |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 标准指南 |
| classification： | Standard guideline |
| 领域： | 管理 |
| field： | Administration |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 一线医师；护理人员；有后续照护需求或有延迟出院风险的患者、家属及其照护者；社会工作者；政策制订者；研究者等群体 |
| Guide users： | Front-line physicians, nursing staff, patients, family members and their caregivers who need follow-up care or are at risk of delayed discharge, social workers, policy makers, researchers, etc |
| 证据分级方法： | GRADE 证据质量分级标准 |
| Evidence grading method： | GRADE |
| 制定单位： | Campbell中国联盟、南京鼓楼医院、南京智荟康养研究院、南医大二附院、南京创加社工师事务所 |
| Formulating unit： | Launch of the Campbell China Network、Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School、Nanjing Zhihuikangyang research institute、The Second Clinical Medical College of Nanjing Medical University、Nanjing Chuangjia Social Worker Office |
| 注册时间： | 2024-04-23 |
| Registration time： | |
| 注册编号： | PREPARE-2024CN570 |
| Registration number： | |
| 指南制订的目的： | 旨在形成出院准备服务标准化指南。 随着我国医疗体制的深化改革和医疗卫生水平的提升，医疗资源的利用率显著提升。我国2022年《关于规范大病患者病床周转率政策的建议》中，提出在保证患者安全出院的情况下，提高医院病床的周转率，缩短住院时长，这也提示了我国住院患者可能面临着“提前出院”“被出院”等困扰。患者转到新的康复环境时，身体尚未完全康复或护理能力有限，我国分级诊疗的体制尚未完全完善，以社区为基础的治疗与康复护理力量较为薄弱。想要实现患者在回归社区和家庭后获得有效的进一步康复和护理，出院准备服务则显得尤为重要。 出院准备服务是一种整合性的过程，需由医护专业人员、患者和主要照护者的多方面合作，以使所有患者在出院后获得持续性的照顾，涵盖院内和院外两个场域。科学、有效的出院准备服务已被多项研究证实有助于控制患者住院时间，降低再入院风险，提升患者自身对疾病的管理能力，有助于患者及家属进行居家康复。国外为推行出院准备服务已出版了许多相关的标准和指南，然而在我国内陆地区出院准备服务发展较晚，尚未形成统一的概念界定和标准化流程等。 基于高质量证据支持，旨在制定标准化的出院准备服务指南，为出院准备服务在我国的实施提供合理的指导性意见，最终促进出院准备服务的科学化和标准化发展。 |
| Purpose of the guideline： | It aims to develop standardized guidelines for discharge preparation services. With the deepening reform of China's medical system and the improvement of medical and health standards, the utilization rate of medical resources has been significantly improved. In China's 2022 "Proposal on Standardizing the Policy on the Bed Turnover Rate of Seriously Ill Patients", it is proposed to improve the turnover rate of hospital beds and shorten the length of hospital stay under the condition of ensuring the safe discharge of patients, which also suggests that inpatients in China may face problems such as "early discharge" and "being discharged". When patients are transferred to the new rehabilitation environment, their bodies have not yet fully recovered or their nursing capacity is limited, and the system of hierarchical diagnosis and treatment in China has not yet been fully perfected, and the community-based treatment and rehabilitation nursing force is relatively weak. Discharge preparation services are important for patients to receive effective further rehabilitation and care after returning to their communities and families. Discharge preparation is an integrated process that involves the collaboration of healthcare professionals, patients, and primary caregivers to ensure that all patients receive a continuum of care after discharge, both in-hospital and out-of-hospital. Scientific and effective discharge preparation services have been confirmed by a number of studies to help control the length of hospital stay, reduce the risk of readmission, improve patients' own disease management ability, and help patients and their families to recover at home. Many relevant standards and guidelines have been published abroad for the implementation of discharge preparation services, but the development of discharge preparation services in China's inland areas is relatively late, and a unified concept definition and standardized process have not yet been formed. Based on the support of high-quality evidence, this paper aims to formulate standardized guidelines for discharge preparation services, provide reasonable guidance for the implementation of discharge preparation services in China, and ultimately promote the scientific and standardized development of discharge preparation services. |
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